Basic Information
Provider Information
NPI: 1477719623
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NARAHARISETTY
FirstName: KALPANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.,
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2100 W CENTRAL AVE
Address2: SUITE 100
City: TOLEDO
State: OH
PostalCode: 436063834
CountryCode: US
TelephoneNumber: 4195375111
FaxNumber: 4195375131
Practice Location
Address1: 2100 W CENTRAL AVE
Address2: SUITE 100
City: TOLEDO
State: OH
PostalCode: 436063834
CountryCode: US
TelephoneNumber: 4195375111
FaxNumber: 4195375131
Other Information
ProviderEnumerationDate: 08/06/2008
LastUpdateDate: 06/04/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X35.120085OHY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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